Healthcare Provider Details

I. General information

NPI: 1043348923
Provider Name (Legal Business Name): LINWOOD ASHWELL ROBINSON JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SOUTH DUKE STREET
SUMMERTON SC
29148
US

IV. Provider business mailing address

PO BOX 398
SUMMERTON SC
29148-0398
US

V. Phone/Fax

Practice location:
  • Phone: 803-485-8521
  • Fax:
Mailing address:
  • Phone: 803-485-8521
  • Fax: 803-485-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberAR6671196
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: